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Patterns of dyspepsia in patients with no clinical evidence of organic diseases

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Abstract

We studied 2000 dyspeptic patients with no obvious signs of organic disease at their first examination, in order to (1) verify how many diagnoses of idiopathic dyspepsia had really been made after exhaustive diagnostic procedures and (2) evaluate the diagnostic power of the symptoms in distinguishing organic from idiopathic dyspepsia. This latter was considered only when no structural abnormalities were found. In all the other cases, a distinction was made between “related” and “associated” organic dyspepsia according to whether or not there was a certain relationship between the abnormalities and the dyspeptic symptoms. The patients were referred to us as follows: (1) spontaneously, (2) sent by physicians collaborating with us, (3) referred to our open access endoscopic service. The results show the frequency of idiopathic dyspepsia was 26%, whereas associated structural abnormalities were present in 45.4%. Obvious organic causes of dyspepsia were seen in 28.6% (24% benign and 4.6% malignant diseases). When considered separately, no symptom alone allows a correct diagnosis. The simultaneous evaluation of the symptoms with linear discriminant analysis distinguishes between idiopathic and organic dyspeptic patients in about 70% of the cases. A higher discrimination percentage in about 70% of the cases. A higher discrimination percentage could probably be obtained using a wider range of clinical parameters and/or a more complex statistical analysis of the interrelationships which exist between the clinical symptoms and the final diagnosis.

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References

  1. Gustavsson S, Bates S, Adami HO, Loof L, Myrén O: Definition and discussion of nomenclatura. Scand J Gastroenterol 20(Suppl 109):11–14, 1985

    Google Scholar 

  2. Barbara L, Camilleri M, Corinaldesi R, Crean GP, Heading RC, Johnson AG, Malagelada JR, Stanghellini V, Wienbeck M: Definition and investigation of dyspepsia. Consensus of an internationalad hoc working party. Dig Dis Sci 34:1272–1276, 1989

    PubMed  Google Scholar 

  3. Talley NJ, Piper DW: The association between non-ulcer dyspepsia and other gastrointestinal disorders. Scand J Gastroenterol 20:896–900, 1985

    PubMed  Google Scholar 

  4. Colin-Jones G: Management of dyspepsia: Report of a working party. Lancet 1:576–579, 1988

    PubMed  Google Scholar 

  5. Talley NJ, Piper DW: Major life event stress and dyspepsia of unknown cause: A case control study. Gut 27:127–134, 1986

    PubMed  Google Scholar 

  6. Roth JLA: Symptomatology.In Gastroenterology. HL Bockus (ed). Philadelphia, WB Saunders, 1974, pp 71–102

    Google Scholar 

  7. Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of the irritable bowel. Br Med J 2:653–654, 1978

    PubMed  Google Scholar 

  8. Boldrini G: Trattato di Statistica. Milano, Giuffrè, 1977

    Google Scholar 

  9. Ismail-Beigi F, Pope CE: Distribution of the histological changes of gastroesophageal reflux in the distal oesophagus of man. Gastroenterology 66:1109–1113, 1974

    PubMed  Google Scholar 

  10. Whitehead R, Truelove SC, Gear MWL: The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol 25:1–11, 1972

    PubMed  Google Scholar 

  11. Whitehead R, Roca M, Meikle DD, Skinner J, Truelove SC: Histological classification of duodenitis in fibreoptic biopsy specimens. Digestion 13:129–136, 1975

    PubMed  Google Scholar 

  12. Acton FS: Numerical Methods at Work. New York, Harper & Row, 1970

    Google Scholar 

  13. Press WM, Flanner BP, Tenkolsky SA, Vetterling WT: Numerical Recipes. The Art of Scientific Computing. Cambridge, Cambridge University Press, 1987

    Google Scholar 

  14. Weir RD, Backett EM: Studies of the peptic ulcer in a rural community: Prevalence and natural hystory of dyspepsia and peptic ulcer. Gut 9:75–83, 1968

    PubMed  Google Scholar 

  15. Jones R: Dyspeptic symptoms in the community. Gut 30:893–898, 1989

    PubMed  Google Scholar 

  16. Jones R, Lydeard S: Prevalence of symptoms of dyspepsia in the community. Br Med J 290:30–32, 1989

    Google Scholar 

  17. Nyren O, Gustavsson S, Adami HO, Loof L: Methodological aspects of clinical trials in non-ulcer dyspepsia with special reference to selectional factors. Scand J Gastroenterol 20(suppl 109):159–162, 1985

    Google Scholar 

  18. Lagarde SP, Spiro HM: Nonulcer dyspepsia. Clin Gastroenterol 13:437–446, 1984

    PubMed  Google Scholar 

  19. Toukan AU, Kamal MF, Amr SS, Arnaout MA, Abu-Romiyeh AS: Gastroduodenal inflammation in patients with nonulcer dyspepsia. Dig Dis Sci 30:313–320, 1985

    PubMed  Google Scholar 

  20. Guslandi M: Nonulcer dyspepsia. Lancet 2:113, 1986 (letter)

    PubMed  Google Scholar 

  21. Levy VG: La lithiase vésiculaire est-elle une maladie? Nouv Presse Med 17:1515–1517, 1988

    Google Scholar 

  22. Bonfils S, N'Guyen Phuoc K, René E: La dyspepsia “non ulcereuse”. Pour un abord rationel des ètudes thèrapeutiques. Gastroenterol Clin Biol 12:187–192, 1988

    PubMed  Google Scholar 

  23. Thompson WG, Heaton KW: Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288, 1980

    PubMed  Google Scholar 

  24. Talley NJ, McNeil D, Hayden A, Colreavy C, Piper DW: Prognosis of chronic unexplained dyspepsia. Gastroenterology 92:1060–1066, 1987

    PubMed  Google Scholar 

  25. Nyren O: Epigastric distress syndrome. Scand J Gastroenterol 22(suppl 128):102–107, 1987

    Google Scholar 

  26. Edenholm M, Gustavsson R, Jansson O, Nilsson O, Söderlind T, Titusson L, Thulin A: Endoscopic findings in patients with ulcer-like dyspepsia. Scand J. Gastroenterol 20(suppl 109):163–167, 1985

    PubMed  Google Scholar 

  27. Rathbone BJ, Wyatt JI, Heatley RV, Lasowski MS: Causes of dyspepsia and other gastrointestinal disorders. Gut 26:A580, 1985 (abstract)

    Google Scholar 

  28. Saunders JHB, Oliver RJ, Higson DL: Dyspepsia: Incidence of non-ulcer disease in a controlled trial of ranitidine in general practice. Br Med J 292:665–668, 1986

    Google Scholar 

  29. Kerrigan DD, Brown SR, Hutchinson GH: Too much to swallow? Br Med J 300:374–376, 1990

    Google Scholar 

  30. Lance P, Gibson-Glubb S, Gazzard JA, Gazzard BG: Chronic dyspepsia pain in general practice—its causes and diagnosis. Postgrad Med J 61:411–413, 1985

    PubMed  Google Scholar 

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Mansi, C., Mela, G.S., Pasini, D. et al. Patterns of dyspepsia in patients with no clinical evidence of organic diseases. Digest Dis Sci 35, 1452–1458 (1990). https://doi.org/10.1007/BF01540561

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  • DOI: https://doi.org/10.1007/BF01540561

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